Improvement of knee function with treatment of spinal joint dysfunction

M. Fukushima
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Abstract

I have continued to study how therapy for spinal dysfunction can benefit peripheral joints, and have now studied 55 consecutive cases of knee problems, with 77 knees being treated. My methods for the spine have been reported in this journal in the past. The therapy consisted of placement of pillow and bar under the trunk and pelvis in side-lying, sitting, and supine. Mechanical dysfunction of the knee joint occurs if joint-play is lost through muscle spasm of the quadriceps and hamstrings or internal derangement of the knee joint such as pinching or displacement of the meniscus, which may be caused by excessive stress or injury. The muscle spasm can be eliminated by the therapy for the spinal joint dysfunction defined by dynamic radiographs. The knee problems were classified into (1) meniscus problems (acute locking/derangement 4 cases, subacute with edema or effusion 3 cases, chronic with restricted flexion 14 cases), (2) periarthritis of ligaments of the knee 10 cases, (3) knee pain caused directly (referred pain) from the spine 20 cases, and (4) contracture of the knee 4 cases. The mean improvement in degrees of flexion was, in group (1) 10, 15, and 13° in the respective categories, in group (2) 3°, in group (3) 1°, and (4) 6°. In all cases except those of contracture, the range of flexion ended at over 140°. As well as radiological determination of joint position and side-flexion range in the thoracic and lumbar spines, three clinical tests for the spine were employed, the gliding test with palpating bar to the thoracic, rib, lumbar and sacroiliac joints, cervical atlanto-axial joint with palpating thumb, and pain provoking test at end-range of flexion. The treatment is carried out by utilizing body weight in side-lying, supine, and sitting. All patients were treated with a small pillow with the core made of rolled paper and of three round wooden bars in order to treat all spinal joints in the static state. Small triangular bars (bars) and oval pillows (pillows) in different sizes are placed under the trunk and pelvis to lift the trunk off the treating table to result in releasing locking of the cervical, thoracic, lumbar, and sacroiliac joints. When joint-play was restored to the knee joint a soft end-feel was sensed for knee flexion and no pain was aroused by pressing the tibia, and there was an increase of external and internal rotation in the elastic ligaments of knee. In the cases of medial radial displacement of the meniscus within group 1, the meniscus itself was reduced by knee traction and rotation. In acute cases treatment was completed in a mean of less than 9 days; contractures were treated for a mean of 48 weeks, while all other cases were treated for less than a mean of 14 weeks.
治疗脊柱关节功能障碍可改善膝关节功能
我继续研究脊椎功能障碍的治疗如何使周围关节受益,现在我已经连续研究了55例膝关节问题,其中77例膝关节得到了治疗。我的脊椎治疗方法曾在该杂志上报道过。治疗方法包括侧躺、坐位和仰卧时在躯干和骨盆下放置枕头和杠杠。如果由于四头肌和腘绳肌的肌肉痉挛或膝关节内部紊乱(如挤压或半月板移位)而失去关节活动,则会发生膝关节机械功能障碍,这可能是由于过度压力或受伤造成的。肌肉痉挛可以通过动态x线片确定的脊柱关节功能障碍的治疗来消除。膝关节问题分为(1)半月板问题(急性锁定/脱位4例,亚急性水肿或积液3例,慢性屈曲受限14例),(2)膝关节韧带周炎10例,(3)脊柱直接引起的膝关节疼痛(牵涉性疼痛)20例,(4)膝关节挛缩4例。各组屈曲度的平均改善程度分别为(1)10°、15°和13°,(2)组为3°,(3)组为1°,(4)组为6°。除挛缩外,所有病例屈曲范围均超过140°。除了胸椎和腰椎关节位置和侧屈范围的影像学测定外,还对脊柱进行了三种临床试验,即胸椎、肋骨、腰椎和骶髂关节用触诊棒滑动试验,颈椎寰枢关节用触诊拇指和屈曲末端疼痛试验。采用侧卧、仰卧和坐位时利用体重进行治疗。所有患者均使用一个小枕头进行治疗,枕头芯由卷纸和三个圆形木棒制成,以便在静态状态下治疗所有脊柱关节。在躯干和骨盆下放置不同大小的三角形小棍和椭圆形枕头,将躯干抬离治疗台,从而解除颈椎、胸椎、腰椎和骶髂关节的锁定。膝关节恢复关节活动后,膝关节屈曲末端感觉柔软,按压胫骨无疼痛感,膝关节弹性韧带外旋和内旋增加。在第1组半月板内侧径向移位的情况下,通过膝关节牵引和旋转使半月板本身复位。在急性病例中,治疗平均在不到9天内完成;挛缩的平均治疗时间为48周,而其他所有病例的平均治疗时间均小于14周。
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